ArticleClinical lymphoma, myeloma & leukemia2026
Comorbidity Burden and Prognosis in Patients Aged 80+ Years With Large B-Cell Lymphoma.
Article in Clinical lymphoma, myeloma & leukemia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPatients aged 80+ years with large B-cell lymphoma (LBCL) represent a growing, vulnerable population where conventional prognostic indices inadequately capture comorbidity burden. We evaluated prognostic value of the Lymphoma Epidemiology of Outcomes Comorbidity Index (LCI) and derived simplified comorbidity model.
methodsIn 539 patients aged 80+ years with LBCL from two independent international cohorts, we evaluated associations between comorbidities/LCI (10 comorbidity categories) and overall survival (OS) or event-free survival (EFS). discrimination and model fit were assessed using C-indices and likelihood ratio tests.
resultsLCI categories were 0 (19%), 1 (31%), 2+ (50%). Higher LCI predicted inferior OS (LCI 1 vs. 0: hazard ratio [HR] = 1.43 [95% CI 1.04-1.97]; LCI 2+ vs. 0: HR = 1.88 [1.40-2.53]), EFS (LCI 1 vs. 0: HR = 1.37 [1.00-1.87]; LCI 2+ vs. 0: HR = 1.78 [1.33-2.38]), and higher 2-year nonlymphoma mortality (11%, 13%, and 26% for LCI 0, 1, and 2+). Heart disease (48%), prior or concurrent malignancy (9%), and stroke (8%) independently predicted OS and were combined into the MaSH Comorbidity Index (MaSH-CI; one point each), with scores 0 (44%), 1 (47%), and 2+ (9%). Higher MaSH-CI predicted inferior OS (1 vs. 0: HR = 1.59 [1.27-1.98]; 2+ vs. 0: HR = 2.43 [1.70-3.47]). Adding LCI or MaSH-CI to International Prognostic Index (IPI) or SENIOR-IPI significantly improved model fit and discrimination across all endpoints (ΔC-index 0.02-0.03).
conclusionMultimorbidity strongly predicts outcomes in LBCL patients aged 80+ years. The simplified MaSH-CI adds prognostic value beyond conventional prognostic indices and offers a practical tool for risk-adapted management.
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